Supraspinal Processing of Sensory Aspects of Pain

项目总结 在美国，慢性疼痛影响着大约20%的成年人和儿童，是 残疾和医疗保健费用。由于慢性疼痛的存在，慢性疼痛的诊断可能具有挑战性 了解症状。确诊后，目前治疗疼痛的药物治疗效果显著 无效，而有效的非药物治疗仍未得到充分利用。这些不足之处在于 疼痛的诊断和治疗源于我们对基础中枢神经知识的巨大差距 处理伤害性信息并实例化疼痛体验的系统。这些差距是 由于缺乏基础/翻译研究，在儿科慢性疼痛的情况下进一步放大。我们的团队 基础科学家和临床科学家在进行综合人类儿科研究方面具有独特的地位 功能神经成像结合定量感觉测试和心理评估来描绘大脑 在慢性疼痛期间，系统参与其中。我们将检查四种不同的慢性疼痛综合征：偏头痛， 复杂性局部疼痛综合征、功能性腹痛和肌肉骨骼疼痛。我们寻求1)识别 不同形式的儿科慢性疼痛共同的和不同的大脑系统决定了 不同的慢性疼痛状况对康复的预测是不同的，3)描绘了相关的大脑系统 随着痛苦的蔓延。我们将在治疗开始后对患者进行为期一年的纵向跟踪，以评估 恢复程度和疼痛蔓延。这项研究将为以下项目提供重要的基础知识 不同形式慢性疼痛的诊断标记物的未来临床试验和新的 治疗慢性疼痛。

PROJECT SUMMARY Chronic pain affects approximately 20% of both adults and children in the US and is a source of substantial disability and health care costs. Chronic pain can be challenging to diagnose due to the presence of poorly understood symptoms. When diagnosed, current pharmacologic treatments for pain are remarkably ineffective, while effective non-pharmacologic treatments remain under-utilized. These shortcomings in the diagnosis and treatment of pain arise from tremendous gaps in our knowledge about the basic central nervous system systems that process nociceptive information and instantiate an experience of pain. These gaps are further amplified in the case of pediatric chronic pain due to a lack of basic/translational research. Our team of basic scientists and clinician scientists is uniquely positioned to perform human pediatric studies integrating functional neuroimaging with quantitative sensory testing and psychological assessments to delineate brain systems engaged during chronic pain. We will examine four distinct chronic pain syndromes: migraine, complex regional pain syndrome, functional abdominal pain, and musculoskeletal pain. We seek to 1) Identify shared and distinct brain systems engaged by different forms of pediatric chronic pain, 2) Determine if predictors of recovery differ across different chronic pain conditions, 3) Delineate brain systems associated with the spread of pain. We will follow patients longitudinally for 1 year after initiation of treatment to assess the degree of recovery and spread of pain. This study will provide a critical foundation of basic knowledge for future clinical trials of diagnostic markers for different forms of chronic pain and for the development of new treatments for chronic pain.